3D DCE-MRA在下肢血管疾病中的临床应用  

THE CLINICAL APPLICALION OF 3D DCE-MRA TO THE VASCULAR DISEASES OF LOWER LIMBS

作　　者：姜华[1] 李秀元[1] 潘宏良[1] 

机构地区：[1]牡丹江医学院附属红旗医院影像科,黑龙江牡丹江157011

出　　处：《牡丹江医学院学报》2008年第4期39-42,共4页Journal of Mudanjiang Medical University

摘　　要：目的:探讨三维动态增强磁共振血管成像(3D DCE-MRA)的方法及在下肢血管病变的临床应用。方法:对疑有下肢血管病变的50例病人进行了3D DCE-MRA检查,用高压注射器经肘正中静脉注射造影剂Gd-DTPA。采用K空间(k-space)中心优先采集技术,3D Flash序列扫描,通过MIP重建图像和减影技术获得满意的下肢三维血管树像。结果:对50例疑怀疑有下肢血管相关性疾病的患者行3D DCE-MRA,分析其图像质量和血管显示情况,优良率达74.66%,显示率达100%;②3D DCE-MRA诊断狭窄>50%的敏感性和特异性分别为99.5%和99.8%,阳性预测值和阴性预测值分别为95.6%和99.8%;③与DSA比较,在<50%的狭窄中,3D DCE-MRA对狭窄程度过高估计,无明显统计学意义(P>0.05),在小腿动脉的完全闭塞有统计学意义(P<0.05);④本组研究的3D DCE-MRA与DSA对3段血管狭窄符合率比较,显示下肢动脉第1段两者符合率最好,达到100%,第3段血管显示质量最差,与DSA的符合率为89.29%,明显不如DSA。结论:三维动态增强磁共振血管成像(3D DCE-MRA)与DSA有很好的一致性,虽然对狭窄程度的高估仍不可避免,仍然是一种高效快速的下肢血管成像方法。Objective：To evalute the method and assess the value of clinical application of 3D dynamic contrast - enhanced magnetic resonance angiography. Methods：Fifty patients suspected of having blood vessel diseases underlying 3D DCE-MRA, they were injected gadolinium contrast medium from an antecubital vein through intravenous bolus with the Spectris MR injector of MEDRAD. 3D Flash sequence was performed. The satisfying 3D image of lower extremity vascular tree was gained and was studied to assessstenosis grading through 3D MIP reconstruction of the subtraction images and integration of anteroposterior MIP images. Results：①3D DCE-MRA were performed in 50 patients with suspected vascular disease of lower extremities. The image quality and the displaying of vessels were evaluated,The displaying rate of the artery 3D DCEMRA was 100% ,the excellent rate was 74.66%.②The cases were diagnosed by 3D DCE-MRA as follows ：50 cases of lower extremity atherosclerosis obliterans in these cases. Compared DSA and 3D DCE-MRA by which showed the grade of arterial lumen stenosis. The sensitivity and specificity for detection of significant stenosis （ ≥50 % ） were 99.5% 和 99.8% respectively,positive predictive value was 95.6%, and negative predictive value was 99.8% ;③Compared with DSA,3D DCE-MRA overestimated the degree of stertosis with ≤50% ,but with no significant difference（ P≥0.05 ） ,overestimated segment with completely occluded small arteries with significant difference （p≤0.05 ）. ④DSA and 3 D DCE-MRA were compared in the accordance of assessing the stenosis of three segments, in displaying the first segment, the accordance is the best, is 100%, the image quality of the third segment was the worst, the accordance is 89.29% , worse than DSA. Conclusion： The accordance between DSA and 3D DCE-MRA was very good, although overestimation of the stenotic degree is difficult to avoid. 3D DCE- MRA is an efficient and fast method in lower limb blood vessel.

关 键 词：磁共振成像 数字血管造影术 血管病变 三维 下肢血管 

分 类 号：R814[医药卫生—影像医学与核医学]